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Syracuse, NY – Dr. Paul Fu is worried.
“We are all worried,” said Fu, deputy chief medical officer at Auburn Community Hospital, whose hospital now receives four to five times more Covid-19 patients than in the spring. “We have seen the numbers increase and all hospitals are concerned about capacity.
The number of Covid-19 patients in central New York City hospitals has reached record levels and is now 75% higher than that frightening first peak of spring. To deal with it, hospitals are expanding intensive care units, postponing elective surgeries, and hiring more staff to replace those exhausted by months of alert and long hours.
“As a healthcare professional, I am really concerned, and my friends and colleagues are concerned about the direction we might take,” said Dr Kathryn Anderson, professor of medicine and immunology at Upstate Medical University. . “We are absolutely back to where we were, with the transmission (of the virus) in our region and the United States escalating to really high levels.”
The number of Covid-19 patients in regional hospitals has quadrupled since Halloween, from 36 to 147. And more patients are expected: Newly confirmed cases have also broken records, and some of those people are at risk of ending up in the hospital two weeks. approximately after infection.
There are glimmers of hope: the patients hospitalized this time around are younger and less sick, we have yet to see a series of vulnerable patients in nursing homes in hospitals, and doctors have over drugs available to them only in the spring. Only a third of hospital patients need intensive care compared to the previous peak in April.
Yet here we are again, with fears that the novel coronavirus pandemic will overwhelm the healthcare system. This is precisely what all of the sacrifices we made in the spring – canceling basketball tournaments, closing schools, staying home for months – were designed to avoid. We wanted empty hospital beds ready not only for people with Covid-19, but also for heart attack patients and accident victims.
In March, the state ordered hospitals to cancel elective surgeries to free up beds, most of which, thankfully, were unnecessary. But these surgeries are producing the profits needed to subsidize other care, and hospitals already operating on low margins have lost millions. The Crouse Hospital alone was losing $ 300,000 a day.
Another ban on these surgeries has not been discussed, but local hospitals are considering cuts themselves. Some surgeries at Upstate have already been moved to other hospitals with more capacity, and a few have already been postponed, hospital executive director Dr Robert Corona said. It’s a day-to-day decision.
“Let’s say for example that some day we would need 10 intensive care beds,” Corona said. “If the analysis shows that we won’t have as many, we would sort out the most needed surgeries and postpone the unnecessary ones to a later date or move them to another location.”
Upstate has already sent a handful of its least ill Covid-19 patients to Auburn Hospital to free up bed space in Syracuse. Upstate is also hiring new nurses and other staff to relieve those who have worked long hours for months, Corona said.
“When we started (in the spring), everyone was excited and excited that we could do this,” he said. “Now our staff are exhausted and exhausted.”
If the current wave of hospitalizations continues to climb, further surgeries may be delayed. Plans made in the spring for additional hospital space, such as building a makeshift hospital at Syracuse University’s Manley Field House, could be dusted off, said Ryan McMahon, director of Onondaga County.
“We’re not there yet,” McMahon said last week, “but we are thinking about these things and preparing for them in case the worst-case scenario arises.”
The worst-case scenario didn’t happen in the spring – hospitals weren’t overflowing and Manley wasn’t needed – but what happened was pretty tragic. In the first two months of the first case of coronavirus in mid-March, 84 residents of Onondaga County have died. This put Covid-19 on track to be the county’s third leading cause of death. The death toll has since climbed to 217.
A post-Halloween spike in coronavirus cases has led to a delayed but inevitable increase in the number of people in hospital. 147 people were hospitalized in the central New York City area on Friday with respiratory illness. The peak in spring: 84.
The region includes the counties of Cayuga, Cortland, Madison, Onondaga and Oswego.
Hospital stays are now a few days shorter than they were in the spring. Doctors have newer treatments, including the antiviral drug remdesivir, the steroid dexamethasone, and convalescent plasma from recovered patients.
“Fortunately, if there is good news, it is that we have learned to manage Covid-19 infections better than we have,” said Tom Dennison, professor of health policy at the Syracuse University and former director of the hospital. “People who get sick are younger and less compromised, so people don’t get so sick.”
This is clear in the percentage of patients who end up in intensive care units in the region. The number of Covid-19 patients in intensive care peaked on April 14 at 40, out of a total of 67 hospitalized. This represented 60% in the ICU.
As of Sunday, 29 of 147 hospital patients needed intensive care, or about 20%.
Fewer people are dying too, in part because so far we have not seen large outbreaks in nursing homes, where the most fragile people would be at risk. In April and May, 131 residents of Onondaga County died. Since October 1, 15 years ago.
However, deaths tend to be several weeks behind infections, so it’s too early to know how many more will die given the recent spike in confirmed cases. McMahon said we should prepare for more.
About a third of the 217 deaths to date in Onondaga County have been patients in nursing homes.
“The death rates have improved, but I’ve been through the first phase – we’ve all done it – and when your nursing homes get cases and your senior centers get cases, we don’t get. not always perform well, “he said.
A nursing home, Loretto, reported on Tuesday that 18 residents had been infected with the virus by an asymptomatic employee. Residents have been transferred to the specialized coronavirus isolation unit in Loretto.
Public health experts have predicted for months that we would likely see a drop in cases and hospitalizations as people move social gatherings indoors. Cases had already started to increase in October, but exploded after Halloween, when many people let their guard down and threw parties. And the next six weeks follow the biggest indoor gatherings of the year: Thanksgiving, Christmas and New Years Eve.
“There are a lot of reasons to be nervous about winter,” Anderson said.
Read more
Cuomo issues warning: parts of Syracuse heading for ‘orange zone’
Coronavirus hospitalizations top 100 in Onondaga County as number of new cases declines
Coronavirus in New York: nearly 6,000 new cases, most since late April
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